Multilevel interventions to undo the health consequences of racism: The need for comprehensive approaches.

The United States is experiencing a resurgence of overt expressions of racism, xenophobia, and other forms of intolerance. These forces have clear deleterious consequences for the health and well-being of many populations of color but also harm Whites. Leadership is necessary to challenge racism operating at structural, institutional, interpersonal, and internalized levels, and interventions should be applied simultaneously and in coordination. Only such comprehensive approaches are likely to reshape policy and practice, as well as individual attitudes and behaviors, in ways that dismantle the belief in human hierarchy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The lived experience of race and its health consequences.

A growing body of research illuminates the mechanisms through which racism and discrimination influence the health status of people of color. Much of the focus of this research, however, has been on individually mediated racism (i.e., acts of discrimination and racial bias committed by White individuals against people of color). Yet research literature provides numerous examples of how racism operates not just at individual levels, but also at internalized, institutional, and structural levels. A more comprehensive model of the lived experience of race is needed that considers the cumulative, interactive effects of different forms of racism on health over the lifespan. Such a model must facilitate an intersectional analysis to better understand the interaction of race with gender, socioeconomic status, geography, and other factors, and should consider the negative consequences of racism for Whites.

Psychology, public policy, and advocacy: Past, present, and future.

This article offers a historical perspective on the contributions of the field of psychology and the American Psychological Association (APA) to the public policy arena. It traces APA's involvement from a 1956 Council of Representatives resolution on the application of psychology to inform public policy to current advocacy initiatives related to psychological science, practice, and education in the public interest. Attention is directed to APA's early policy structures together with the development of affiliated state, provincial, and territorial psychological associations and the first political action committee for psychology. The criteria for engagement in advocacy and the goals and functions of APA's policy and advocacy initiatives, including the APA Congressional and Executive Branch Science Fellowship Program, are also discussed. The evolution of psychology's public policy role is illustrated by an increasing level of federal advocacy engagement and effectiveness over time, as well as by the emergence of psychology leaders in Congress and the Executive Branch. The authors' concluding reflections on the future of psychology in the public policy arena derive from their many years of experience working on or with Capitol Hill, at APA as elected officials or senior staff, and in various roles in academia, think tanks, service delivery, and the private sector. (PsycINFO Database Record

Expanding the frame of understanding health disparities: from a focus on health systems to social and economic systems.

Policy makers are increasingly attending to the problem of racial and ethnic health disparities, but much of this focus has been on evidence of inequality in health care systems. This attention is important and laudable, but eliminating inequality in the health care system would be insufficient to eliminate racial and ethnic disparities and improve the health of all Americans. Social and economic factors, such as disadvantaged socioeconomic status, racism, discrimination, and geographic inequality shape virtually all risks for poor health. Interventions that focus solely on improving access to health care, or on reducing individual behavioral and psychosocial risks, therefore have limited potential to reduce racial and ethnic health disparities. The elimination of health disparities requires comprehensive, intensive strategies that address inequality in many sectors, including housing, education, employment, and health systems. These interventions must be targeted at many levels, including individuals and families, workplaces, schools, and communities.

Race as biology is fiction, racism as a social problem is real: Anthropological and historical perspectives on the social construction of race.

Racialized science seeks to explain human population differences in health, intelligence, education, and wealth as the consequence of immutable, biologically based differences between "racial" groups. Recent advances in the sequencing of the human genome and in an understanding of biological correlates of behavior have fueled racialized science, despite evidence that racial groups are not genetically discrete, reliably measured, or scientifically meaningful. Yet even these counterarguments often fail to take into account the origin and history of the idea of race. This article reviews the origins of the concept of race, placing the contemporary discussion of racial differences in an anthropological and historical context.

Moving beyond access: achieving equity in state health care reform.

The Institute of Medicine's 2003 Unequal Treatment report raised the public's and policymakers' awareness of racial and ethnic health care disparities, but federal policy-makers have implemented few of the report's more than two dozen recommendations. State health care reform efforts, however, are gaining support around the country and have great potential to reduce health care inequality. This paper offers a policy framework to explore how states can move toward eliminating disparities by addressing health care access and quality, state health care infrastructure, patient and community empowerment, state policy infrastructure, and social and community determinants of health.